Healthcare Provider Details

I. General information

NPI: 1114372851
Provider Name (Legal Business Name): CHELSEA SHMUEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA SIMENHOFF MD

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 EVESHAM ROAD
VOORHEES TOWNSHIP NJ
08043
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-795-4330
  • Fax:
Mailing address:
  • Phone: 856-355-0340
  • Fax: 856-355-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA10490000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: